The Radiology of Pituitary Adenomas—An Update
Prior to the utilization of sellar tomography in patients with intrasellar tumors, adenomas less than 10 mm in diameter were seldom detected radio-graphically. The application of pluridirectional and, more recently, computed tomography (CT) of the sella to the workup of these patients has revolutionized their management. Patients with tumors ranging in size from 5 mm in diameter to large supra- and parasellar masses can now be medically or surgically managed entirely on the basis of tomography, CT of the sella, the endocrine findings, and the visual-field examination. Pneumoencephalography (PEG) is now seldom indicated in these patients, though on occasions, particularly when an empty sella is suspected, the definitive diagnosis is achieved by PEG. Even more recently, a water-soluble contrast agent, metrizamide, for subarachnoid space opacification has been introduced. The agent can be maneuvered into the suprasellar cisterns, and the use of metrizamide cisternography with CT may eliminate PEG in the few instances in which it is still presently indicated (see Chapter 10, Fig. 19).
KeywordsPituitary Adenoma Sphenoid Sinus Anterior Clinoid Process Sellar Floor Suprasellar Tumor
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